Provider Demographics
NPI:1477614907
Name:ADAIR, LAURA JANE (LMP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JANE
Last Name:ADAIR
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 E SUNSET WAY
Mailing Address - Street 2:#163
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-3813
Mailing Address - Country:US
Mailing Address - Phone:425-391-3939
Mailing Address - Fax:425-313-0198
Practice Address - Street 1:1595 NW GILMAN BLVD STE 15
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5329
Practice Address - Country:US
Practice Address - Phone:425-391-3939
Practice Address - Fax:425-313-0198
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016109174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist